Ears Suddenly Go Deaf, Toothache, or Fainting Out of Nowhere? Doctor Ni Haixia on the Complete Miao Ci Bloodletting Manual and Corpse Syncope First Aid, from the Huang Di Nei Jing

Patient search terms: my ears suddenly went deaf / sudden hearing loss / I hear wind blowing in my ear / toothache / swollen gums / sore throat so bad I cannot swallow saliva / heart pain that wanders around / low back pain / cramps / I cannot lift my thigh / my inner thigh is numb / sudden fainting and unconsciousness / I cannot urinate / blood in the urine / bruises on my body / bloodletting / acupuncture / Huang Di Nei Jing

Corresponding medical names: the Su Wen · Miao Ci Lun (Discourse on Opposite-Side Needling), Chapter 63, closing section — the complete needling and bloodletting manual for collateral disease (sudden deafness, wind in the ear, wandering heart pain, needling by the phases of the moon, the yang ming collateral’s nosebleed and cold upper teeth, the shao yang collateral’s rib pain and the stream-valley theory, warm care for coughing patients, the foot shao yin collateral’s throat pain, the spleen collateral’s low back pain, the bladder collateral’s cramps, the gallbladder collateral’s hip pain, toothache, pathogenic qi lodging between the five organs, and the five-collateral corpse syncope with the Bian Que story and full first-aid protocol) — plus the Su Wen · Si Shi Ci Ni Cong Lun (Discourse on Counter-Order Needling in the Four Seasons), Chapter 64, opening section (the six channels’ excess and deficiency and their bi syndromes, the slippery and choppy pulses and their hernias, the small intestine’s fire qi transforming the bladder, and a critique of trusting instruments over the body).

Opening: your ears suddenly went deaf? First tell deficiency from excess — only bleed the excess

This lecture continues straight on with the Miao Ci Lun. Right at the start: what to do when the ears suddenly go deaf.

This kind of deafness can make a person unable to hear — “the ears become deaf, and food and sound are no longer perceived.” Doctor Ni Haixia says: this deafness happens in an instant — two or three days, a day or two. It is not a case of “Teacher, how long have I been deaf?” “Ten years” — that has nothing to do with this. Ten years has already entered the organs (zang). If the illness is on a collateral (luo), it has not even entered the channel (jing) yet.

So sudden deafness — the disease sits on the collateral. How do we needle it?

💬 Note from Doctor Ni Haixia: When the attack comes, we prick a little blood on Shao Shang (LU11) and Shang Yang (LI1) — as soon as you let a drop out, he can hear again. If it has not improved, we prick a little blood on Zhong Chong (PC9) as well, and he can also hear immediately.

The key is telling deficiency from excess:

💬 Note from Doctor Ni Haixia: If this deafness sometimes hears and sometimes does not — remember this, everyone: when the excess pattern appears, the symptom is continuous; when the deficiency pattern appears, sometimes it is better and sometimes it is not. If it is the deficiency pattern, do not bleed, because the person is already deficient — we must distinguish deficiency from excess. Once it is deficiency, do not bleed any more.

Wind blowing inside the ear? Hold a conch shell to your ear

What about “wind in the ear” (er zhong sheng feng)? Qi Bo says the needling method is the same.

Wind in the ear does not mean you touch the ear and a wind blows out of it — no. It means the patient tells you: I hear wind blowing in my ear, the sound of wind. And how do you know it is the sound of wind? Hold a conch shell or something of that kind against your ear and you will hear something like the sound of wind — that is the wind sound they are describing.

Heart pain that wanders: wherever it hurts, needle there

Next: “heart pain that comes and goes” — heart pain that comes and goes, moving without a fixed place. It hurts here, then sometimes shifts and moves around.

For this kind of pain, we needle between the muscles (fen rou), never on the channel itself. Just find the tender point: where does it hurt? Oh, right here — press, find it, one needle goes in.

Needling by the phases of the moon? Count follows the moon’s death and birth

This needling counts by the death and birth of the moon:

From the first to the fifteenth — the first, second, third… up to the fifteenth, you needle fifteen times; after the fifteenth, decrease. If you go over and needle too much, “qi escapes and does not return” — the true qi leaks out, and what cannot leak out is instead wounded.

The yang ming collateral: nosebleed and cold upper teeth — needle Nei Ting (ST44)

The last paragraph on page 512: if the pathogenic qi sits on the collateral of the foot yang ming — and here Doctor Ni stops to make a special point:

This passage is clearly about collaterals, so I suspect the character “yuan lin wen” must be “ruo” (the collateral) — the original text says collateral, because everything here is about collaterals; why would a “sinew” suddenly appear? It should be “collateral.” It makes a person’s nose bleed and the upper teeth ice-cold — when you see these symptoms, you know it is the yang ming collateral, and at this point we needle Nei Ting (ST44).

The shao yang collateral: rib pain — needle Xia Xi (GB43), and the stream-valley theory

Page 513: just now it was the yang ming collateral; now it is the shao yang collateral, which causes rib pain.

Remember, everyone: the yang ming channel descends and lands here — because the yang ming main channel passes through here; and the shao yang channel runs along the chest and ribs, does it not? The blood collaterals are blocked, “unable to get through, unable to sweat” — at this point we needle Xia Xi (GB43). Why does this relate to the previous section? Look: next to the bone — why are Xia Xi, Xing Jian, and the rest all in the middle of streams and valleys? Look at your own hand, notice: when a mountain comes down, the mountain head comes down like this, branching many times — these are all places where flowing water forms streams and valleys. The places of streams and valleys are the places of collaterals.

Coughing patients, remember: the lungs love heat, the heart loves cold

After the collaterals, Doctor Ni inserts a piece of everyday care knowledge for coughing patients:

💬 Note from Doctor Ni Haixia: If a patient has a cough — a deficiency-pattern cough — we should warm the food and drink, and keep the body warm; also add more clothes and eat warm food. Always remember: the lungs love heat, the heart loves cold. So whenever you know the lungs have any problem, you must tell the patient: put on more thick clothes and keep the body warm — because the lungs govern the skin and body hair; when the lungs have a problem, the skin and body hair are certainly weak. If you dress more warmly, heat is generated: the first benefit — the skin and body hair no longer suffer wind-cold, so wind-cold cannot come back in and pile illness on illness; the second — the lungs themselves govern yang and govern the chest, and yang loves heat; in this condition it is better to be a little warm.

Bonus odd trick: heart disease — soak your feet in cold water

Between needling and herbs, Doctor Ni adds a strange external-care case:

Needling and herbs, and you can also combine external care for the heart — for example, heart disease: I teach him to take a cold shower. But in winter an old person taking a cold shower is very painful, right? So at least use cold water to rinse the feet — soak the feet in cold water. By noon the next day the patient’s appetite has opened wide — the effect is excellent.

Sore throat so bad you cannot swallow saliva: the foot shao yin collateral

Next, the foot shao yin collateral — “the illness is on the foot shao yin’s collateral, causing a sore throat”:

💬 Note from Doctor Ni Haixia: Do you remember how we treat sore throat? We needle Lie Que (LU7) and Zhao Hai (KI6). Why Zhao Hai? Because the kidney channel lands on the throat, at the root of the tongue, around Lian Quan and Yu Ye. At this point eating cannot go down — no problem: let the collateral qi rise, it travels up the arm, and rushes up to the throat — at this point we can needle Yong Quan (KI1) on the foot. “Teacher, Yong Quan is so small — for a sore throat you needle Yong Quan?” It is on the collateral. Actually you do not have to needle Yong Quan — Yong Quan is on the sole of the foot, very sensitive; if you take a needle and bleed it there, it hurts a lot; just bleed on the toes instead.

Page 514 is also about sore throat — but so severe that the person cannot swallow saliva; often the saliva cannot even go down, and it hurts very much:

For this kind you can needle around the cartilage. Not on the cartilage, not on the point — around the cartilage you can see many green veins emerging; you can needle all of them. This is disease on the collaterals.

The original meaning of miao ci: illness young, illness on the collateral — let it out quickly

Why does this lecture teach miao ci? Doctor Ni points out the core idea:

Why do we talk about miao ci here? It means: at the very beginning of the illness, while it is still on the collateral and has not yet grown into a great affliction, you let it out. In the future, when you are a doctor, patients will not come to you for every little ailment; for yourself and your family — you know your family sits there watching television; look at whether their feet have green veins, and let them out. Mom talks on her cellphone — let hers out too. While the disease is at its very start it sits on the collateral: for external illnesses, at least we can resist them — let them out while they are on the collateral. Of course your own family members suffer more — they do not understand; how unlucky, the moment you get close to me you get bled.

The spleen channel collateral: low back pain and no rest — needle the jiaji (BL30)

If pathogenic qi sits on the foot tai yin (spleen) collateral, it causes low back pain and pain on both sides of the lower abdomen (the spleen governs the lower abdomen), so the person cannot rest, cannot breathe properly:

💬 Note from Doctor Ni Haixia: This is on the bones of the lower back — we needle the “shen” on the back bones — this character is read shen: it is the jiaji, the two slabs of flesh beside the spine next to the governor vessel, the paraspinal muscles — the tenderloin meat. This is what is called yao shu — mind you, not the yao shu (GV2) of the governor vessel, but the Bai Huan Shu (BL30) beside it.

The bladder collateral: cramps, a tight back — press the tender point and needle

Page 515: if pathogenic qi sits on the foot tai yang (bladder) collateral, it causes cramps, the back becomes very tight, and the pain pulls into both flanks:

At this point we count the vertebrae from the neck, follow the jiaji, and needle where it hurts when pressed. When the disease is on the back, on the collateral, follow the channel, needle where it hurts on that side — press and find the tender point, and needle it.

The gallbladder collateral: pain at Huan Tiao (GB30), the thigh cannot be lifted

If pathogenic qi sits on the foot shao yang (gallbladder) collateral, it causes pain in the bi (thigh) — that is Huan Tiao (GB30), the shao yang collateral’s point; bi bu ke ju — the thigh cannot be lifted:

💬 Note from Doctor Ni Haixia: At this point we needle Huan Tiao (GB30) directly. When needling Huan Tiao use a filiform needle, insert and retain for a long time. When I needle Huan Tiao with a filiform needle, I use a fine needle, a rather long one, and when it is on the bone, I insert very deep. Once it is in — everyone, watch whether my Huan Tiao pain is gone? Insert, inhale, count — then we do the treatment for bone bi. It is very cold in there, so we use that breathing method of tonification and drainage.

The great principle on page 515: if the main channel is not sick, it is the collateral — miao ci

After all this, page 515 lays down the great principle:

He says: when you treat (needle), if all the channels the illness passes through are not sick, then miao ci it. Very simple: look at his symptoms — if the great channel, the main channel, is not sick, then it is collateral disease. Simply put, that is it.

Then he illustrates with deafness:

💬 Note from Doctor Ni Haixia: Deafness — needle the hand yang ming and it does not improve… if this deafness, you needle the hand yang ming and bleed, and the ear is still deaf, then needle Ting Hui (GB2, the tender point in front of the ear). To find the tender point, chopsticks are best: the head of a chopstick is round; when you press, you will find only the real tender point. If you press with something very sharp, everywhere hurts — that is skin pain, so you would be needling the skin. Press with the hand: the fingernail is very sharp, pressing everywhere hurts, that is the pain of the nail pressing. Clip the nail off, press with the flesh — a whole expanse of wrist, you cannot find the tender point. So use a chopstick — in my American clinic I use that steel, round-headed one, best; press it on the collateral vessel; if you truly have none, lightly press with the round head of a chopstick and you will find the true tender point — then let a little blood out and it is done.

Toothache? If needling the channel fails, bleed the gum

Page 516, toothache. Doctor Ni first clarifies which channels govern the teeth:

💬 Note from Doctor Ni Haixia: Usually we needle the hand yang ming and the foot yang ming. The foot yang ming governs the lower teeth and the front teeth — the front teeth belong to the foot yang ming; pain in the upper teeth at the sides belongs to the hand yang ming. What if you needle them and it does not heal? Then needle the place of his vessels: the tooth hurts, it is swollen here, very swollen — you needle beside the tooth, at the vessel between two teeth, insert and bleed. And when you are inside this place, if you yourself have the pain, needling is awkward, not handy — you cannot bring yourself to do it; the person beside you inserts the needle. So if the channel has not been treated well — if the pain is on the channel, needling the channel is fine; if needling the channel has not cured it, at least it is still on the collateral — then bleed: beside the tooth, on the gum, let the blood out.

Pathogenic qi between the five organs: no illness at all, yet the whole body aches

The middle line of page 516: pathogenic qi lodges between the five organs and causes illness — the qi is neither in an organ (zang) nor in a bowel (fu), but between the five organs:

💬 Note from Doctor Ni Haixia: At this point the pulse is led into pain, coming and stopping — that is the illness, and we miao ci it on the fingernails and toenails of the hands and feet. This kind of pain sometimes hurts, sometimes does not; it will not be continuous. There is a kind of pathogenic qi lodging between the five organs — it is not on the collateral — and for this we can also use miao ci. How do we know the illness is between the five organs? Very simple: this person has no illness at all — can eat, can drink, can move the bowels, can sleep; the hands and feet are warm, the head and face are cool; the stool is all normal — and yet it hurts, pain inside the body. You have no illness, right? Everything is fine. Then we know it is pain between the organs. At this point we can still miao ci: on the sides of the palms and soles, find the green veins and bleed them.

The centerpiece: all five collaterals sick together — the person is like a corpse. This is “shi jue” (corpse syncope)

The last line of page 516, then page 517: this lecture’s most brilliant passage — the five collaterals meet in the ear; when all are sick, corpse syncope.

💬 Note from Doctor Ni Haixia: If this pathogenic qi spreads to the teeth, runs from the collaterals to the teeth and causes tooth pain, toothache with pure cold — for this cold pain, bleed where the vessels on the back of the hand are congested. Generally speaking, above the foot yang ming, the hand yang ming and the foot yang ming — that is, speaking of the stomach — the Nei Ting (ST44) on the stomach channel will do. The points we most often needle for toothache are Nei Ting and He Gu (LI4); with He Gu you can lift a little higher, needling between the stream and the valley. Toothache needling He Gu — because it is on the collateral — the moment this needle goes in the pain leaves. Now you know why — back then I wondered about He Gu: “if the face and mouth, He Gu collects” — for acne, or facial paralysis, we needle He Gu and it is done; for toothache, needling He Gu does not work — you must needle beside the stream-valley, at the side of the mountain valley, and the toothache will be much better.

Page 517: this pathogenic qi is on the collaterals of the hand shao yin and foot shao yin, the hand tai yin and foot tai yin, and the foot yang ming — these five collaterals:

💬 Note from Doctor Ni Haixia: The hand shao yin, foot shao yin, hand tai yin, foot tai yin, plus the foot yang ming — all five of these collaterals meet inside the ear — five collaterals, two yin and two yang, plus one foot yang ming, all meeting inside the ear, and ascending to the collateral on the left foot… the left corner of the head — this is rather special: the left corner of the head. If all five collaterals are sick at once — this is very rare, rather special, you should note it down — it causes a person’s vessels all to move while he knows nothing: the patient’s whole body vessels jump, but he has fainted. This disease is called corpse syncope (shi jue).

Bian Que cures the crown prince of Guo: a legend

Speaking of corpse syncope, Doctor Ni tells the famous ancient case — Bian Que curing the crown prince of the state of Guo:

💬 Note from Doctor Ni Haixia: Do you remember when we studied acupuncture — did the crown prince of Guo have corpse syncope? Bian Que came. At that time all doctors were called Bian Que — Bian Que was a synonym for doctor. Among them there was one Bian Que whose name was Qin Yueren. Qin Yueren knew corpse syncope, and Qin Yueren cured him. After he cured him, the king of Guo issued a decree: only Qin Yueren may be called Bian Que; all the others are called lang zhong (attending physicians). That is why later generations were all lang zhong, and only Qin Yueren was called Bian Que. At that time the crown prince of Guo had corpse syncope: unconscious like a corpse, but if you feel his qi and vessels they are all good — the five-organ vessels, the whole body’s vessels all move — at this point we know how to treat corpse syncope.

The complete first-aid: prick the well points, blow in the ear, shave the hair, drink a cup of wine

How is corpse syncope treated? Everyone, remember this first-aid sequence:

💬 Note from Doctor Ni Haixia: The hand and foot shao yin, the hand and foot tai yin, plus the foot yang ming, land on the ear and the left forehead corner, the left head corner. At this point we prick the big toe — the foot tai yin spleen channel’s Yin Bai (SP1, a well point). In first aid we always treat at the well points. Sometimes it is the sole of the foot — the foot shao yin kidney channel’s Yong Quan (KI1) on the sole — at this point you needle the sole, no need to needle the fingers — the person has fainted; the fingers have no strength; you must needle the sole. Then the thumb is the hand tai yin lung channel’s Shao Shang (LU11), and the hand shao yin (heart channel) well point must also be needled. The foot yang ming channel’s well point must also be needled. After needling, he should wake up — we know the two yin and two yang: the hand’s two yin, the foot’s two yin, plus one yang, the foot yang ming channel.

If he still has not woken up? There is another masterstroke:

💬 Note from Doctor Ni Haixia: Take a bamboo tube and blow into his ear. Blowing into the ear with a bamboo tube is interesting: the ear is where kidney qi resides; when you blow into the ear, the whole ear is sealed shut; when the pressure increases, it rebounds inside — like a balloon: now it has been pumped to one side; you push it, and when you release it, it rushes out. If the qi is trapped in the body and makes the person faint — it is yang qi diseased in the upper part; if you blow once, the yang qi comes out and is released, and the person wakes up.

Qi Bo says it still has not worked? Then the corpse syncope is very deep:

💬 Note from Doctor Ni Haixia: Shave the hair on the left side of his head, the left forehead corner. Shaving the hair — of course if he is your enemy you can do many things: use a razor and scrape a bit more, take the chance, scrape some more, right up to bald. A doctor must not be that wicked — anyone can see you are taking private revenge. This “fan zhi” means to burn or heat it — for example, moxa fumigation, or steaming, or burning it hot and pressing it down — because the left foot side is where yang qi gathers, so we shave the left, not the right.

And finally, one cup of wine:

Then give him a fine cup of wine. “Teacher, a fine cup of wine — what is your definition? Shaoxing wine, yellow wine?” You are being fussy! Whatever — give him a cup of wine, sorghum liquor or anything; the point is to save a life.

Doctor Ni also shares his own clinical experience:

💬 Note from Doctor Ni Haixia: Corpse syncope is rarely seen now, but you will meet people who faint for no reason: feel the pulses of his hands and feet — in all my clinical years I have met it only once — and that time I did not even need to shave the place or blow into the ear: with just the two yin channels on the two hands, the two yin channels on the two feet, plus one foot yang ming channel, I woke him up. You say, Teacher, I cannot remember? No problem — bleed them all! Bleed all the well points first — if you cannot remember, you panic, let them all out. When this person faints it is funny: you feel his pulse and the body is still moving, because yin and yang are separated, and the yang qi is moving; you feel his muscles and they jump by themselves.

The rule of miao ci: any bruising on the skin of the four extremities — let it all out

Page 518, the last passage of the Miao Ci Lun, gathers the rule of miao ci:

💬 Note from Doctor Ni Haixia: All needling rules: the rule of needling — first look at his channels, press along them with the fingernail, follow the course of the vessels and insert, then look at the deficiency and excess and regulate accordingly. If it is excess, we use draining; if deficiency, we use tonifying. If neither tonification nor drainage works, we miao ci — needle again and it is done. “When there is pain, and the channels are sick, miao ci”: the patient has pain, but the channels are not sick — he has pain, yet there is nothing wrong on the channels — at this point we know the disease is on the collaterals, and we use the miao ci method.

So now it is completely clear to everyone: miao ci and ju ci are entirely different things.

💬 Note from Doctor Ni Haixia: In acupuncture, the vast majority of the time we use ju ci, because the disease is on the channels; some cases have no disease on the channels — the pain is on the collaterals, so the patient often tells you “my pain is right here” — you look and think, strange, there is no channel here; it is a collateral. Then you say, “the collateral is here — which one is it?” Look at which main channel is closest to it; the collateral is right there. Pull his foot up, look where — behind which toe — there is bruising; needle it and bleed. It hurts a lot — but actually he is scared well. So “si mo pi bu xue ruo”: as long as you see on the skin, on the skin of the extremities, any bruising — you can let it all out. That is the count of miao ci, its rule. So when you sit there with nothing to do watching television, and a family member has a bit of bruising there, let it out — very good: the illness is still young.

Transition: Chapter 64, the Si Shi Ci Ni Cong Lun — the home of six-channel pattern discrimination

Page 519: entering Chapter 64 of the Huang Di Nei Jing, the Si Shi Ci Ni Cong Lun (Discourse on Counter-Order Needling in the Four Seasons): about the four seasons’ qi, and how we needle its counter-order — when the disease has rebellious qi, how to treat it. Doctor Ni first makes a big declaration:

💬 Note from Doctor Ni Haixia: Here the cold damage school’s six-channel pattern discrimination is defined — see that? So I do not know where the warm disease (school’s) qi-blood-nutrient-defense pattern discrimination comes from. We first read the Huang Di Nei Jing, and what we see throughout is six-channel pattern discrimination; later Zhong Jing — when we teach the Shang Han Lun and the Jin Gui Yao Lue — everything is six-channel pattern discrimination. And we know that viruses triumph over cold, and only with cold is there warm disease — but they (only talk about) warm disease and do not care about cold, and usually (the warm disease) is not cured. We discriminate patterns by the six channels; they discriminate by qi-blood-nutrient-defense — I do not know how that is supposed to work.

Jue yin: numbness of the inner thigh — the hardest to treat

First, the jue yin channel’s excess and deficiency:

💬 Note from Doctor Ni Haixia: If the jue yin channel has excess, the disease is yin bi — numbness of the inner thigh. So we are most afraid of a patient telling us “alas, my leg is numb”: where is it numb? Numb on the outside — look, it is on the gallbladder, stomach, or bladder channel — all easy to treat; numbness on the inside is hard to treat, because it is a yin channel. Yin channels are hard to treat; we hope the numbness is on the yang channels. If jue yin is deficient, then heat bi arises — excess is yin bi, deficiency is heat bi: because when yin qi is insufficient, on the yin channel, yin qi is not enough, yang qi comes up, and you get heat symptoms; with excess — you are originally on a yin channel, yin has excess, yang cannot come over, and it is cold, the yin-cold yin bi.

How to read the pulse?

A choppy (se) pulse means qi accumulation in the lower abdomen — what is called choppy is that the yang pulse is choppy; a slippery (hua) pulse means the disease is fox hernia wind (hu shan feng). Later we will have a lecture devoted to hu huo — it looks like “diu gao” (Taiwanese dialect), a person who is delirious; we have a whole lecture on this. A slippery pulse generally means attacked by wind — wind pulses are slippery, fairly full; but if the pulse on the hand is choppy, a choppy pulse has no strength, soft and weak, sometimes stopping, sometimes not coming — this is qi accumulation in the lower abdomen, a phenomenon of congealed blood and qi.

Shao yin and tai yin: rashes and numb flesh

Shao yin with excess:

Shao yin excess causes skin bi and latent rashes — below the skin, we break out in rashes. When deficient, there are lung problems. Why is shao yin related to the lungs? Because when the kidneys are insufficient they affect the lungs: metal generates water — the lungs are above, the mother, who nourishes and cares for the kidneys; now the kidneys are insufficient, dragging down the mother. Deficiency is lung bi — lung bi is called disease of the skin and body hair, because the lungs govern the skin and body hair. A slippery pulse means lung wind hernia; a choppy pulse means accumulation and blood in the urine — urine with blood in it, that kind.

Tai yin with excess? Tai yin is the spleen channel:

💬 Note from Doctor Ni Haixia: Tai yin excess causes flesh bi — the muscles have a sense of not being there, numb and unfeeling, or the muscles atrophy. Generally speaking, when the spleen has problems, most are cold: when yin has problems it is cold, and in cold patterns the spleen governs transport and transformation. In Chinese medical thought, the spleen governs (transport and transformation). The spleen governs the lower abdomen — the lower abdomen is this region of the belly. Food eaten in the stomach then enters the small intestine — the small intestine is extremely hot, it is fire: the small intestine’s fire comes from the heart; the heart beats and follows the arteries down, this heat enters the small intestine, making the small intestine extremely hot. Precisely because it has heat, the small intestine is the sea of grain and water, the official of receiving and transforming — no matter how much food enters the small intestine, the small intestine digests it. The spleen governs the lower abdomen, so Chinese medicine holds that the spleen governs blood: the whole body’s blood is governed by the spleen; the spleen governs the four limbs and governs the muscles — after the spleen receives the nourishment, it irrigates the four limbs; only then do our muscles have strength and the blood is sufficient.

Why can the spleen transport and transform? Doctor Ni teaches a very important concept — yang:

💬 Note from Doctor Ni Haixia: The reason the spleen can digest everything, assist transport and transformation, and send nourishment to the four limbs — is that the spleen has yang — this yang means its kinetic energy. If the spleen has much fluid and much blood inside — we see the spleen governs blood, and this blood is the moving (visible) part. What Western medicine sees now is the blood; it cannot see the shen — that is, yang — it cannot see yang. Does yang exist? It exists! I often tell everyone: inside your arm, you can see skin, muscle, bone, channels and vessels — and there is strength; you know there is strength — you certainly have not measured it, you do not know how great the strength is; that strength is yang; what you can see is yin.

Critique: the body never lies to you — instruments do

Tai yin deficiency causes spleen bi; a slippery pulse means spleen wind hernia; a choppy pulse means accumulation — because the spleen governs the lower abdomen, the belly distends, cold attacks, the blood congeals, and accumulations form. Doctor Ni then discusses how to treat “accumulation”:

Everyone, in the Chinese medical view, the moment there is an accumulation (ji) — the moment one is found, remove it at once. Remove it, and then when a great illness comes? So we begin to treat while the illness is still small. Chinese and Western medicine differ: Western medicine says wait until the disease breaks out — once you see the illness, then act — that is already too slow; Chinese medicine treats at the first sign of trouble — you do not have a great illness yet.

He tells a truly distressing real case:

💬 Note from Doctor Ni Haixia: It often happens like this — the other day I told you two cases: a man goes to the hospital in the morning and tells the Western doctor “my heart hurts terribly, I am certain I am going to have a heart attack.” The doctor runs an EKG, even a stress test — “you are perfectly fine,” and sends him home. In the evening he comes back, his face twisted with pain; the doctor is scared to death, hurries him onto the EKG, the (screen) is still spinning: “Sir, you really do have heart disease.” Finally the (patient) says: “Doctor, I told you this morning I had heart disease; you did not believe me; now I have made the trip for nothing.” — I heard and saw these two cases; I do not know how many times it has happened. The patient dies in front of (the delay of) treatment. At the very beginning of illness, there are always symptoms: the human body — you absolutely must believe your body, you absolutely cannot believe instruments — the body will never lie to you. That is why Chinese medicine talks about the person from beginning to end and never borrows instruments to look. You must believe a person’s body is never that bad: yesterday fine, today the disease breaks out — there is no such disease — unless it is an accident, a car crash.

How do you guard against an accident? Doctor Ni gives a method of reading the complexion:

I already taught you about car accidents: glance at the eyes — in that dazed moment, is there (an omen)? If you cannot see it, then practice: draw qi, observe qi — pull up the qi, the colors red, orange, yellow, green, blue, indigo, violet; take that line and practice it under dim lamplight.

Yang ming: no cold patterns — all heat. Bai Hu Tang and Cheng Qi Tang

Yang ming excess and deficiency:

💬 Note from Doctor Ni Haixia: Yang ming excess causes vessel bi (mai bi), and the body periodically breaks out in heat; deficiency causes heart bi (xin bi). A slippery pulse means heart wind hernia; a choppy pulse means accumulation. When yang ming patterns appear there is no cold pattern — all heat: the moment you see a person with all heat, it is yang ming. Within yang ming we distinguish channel heat (jing) and bowel heat (fu): the fu is the digestive system — we know the stool is not moving, bowel heat, right? We use some Cheng Qi Tang; for channel heat, we use Bai Hu Tang — possibly thirst, craving drink; if Bai Hu (Tang) cannot stop the thirst, avoid (using it, use Cheng Qi instead) — “I have a high fever.” As for you saying “Teacher, I do not want to use Da Cheng Qi” — whatever; as long as you reach the goal it is fine: get the stool out, the heat retreats, the fever breaks and it is done.

Tai yang and the bladder: urine cannot come out — water flows backward into the kidneys

Tai yang disease:

Tai yang disease causes bone bi — tai yang and the kidneys are interior-exterior, so it can cause bone problems and a heavy body; deficiency causes kidney bi — tai yang and the kidneys are interior-exterior; with excess and deficiency, if deficient it affects the kidneys. If the pulse is slippery, the disease is kidney wind hernia; a choppy pulse also causes accumulation. The kidneys can develop lin ji (urinary obstruction) — what is called lin ji: tai yang governs the foot tai yang bladder channel and the bladder muscle; if you have this disease, urine is easily unable to come out, and it will affect the kidneys.

Why can urine not come out? Here Doctor Ni explains the Chinese medical theory of bladder qi transformation:

💬 Note from Doctor Ni Haixia: How does urination work in a normal person? The small intestine is fiery hot, and the bladder is in front, sticking right behind the small intestine. When water moves from the ureters, from the kidneys into the bladder, in a normal person the water meets the fire and is vaporized — so the urine in the bladder becomes like steam, distending the bladder: it puffs up, the bladder becomes big like a hot-air balloon — that is why we have a 40 cc (residual) urine volume in the bladder. This hot qi, the good hot qi, returns from the bladder to the liver and helps the liver metabolize. Now suppose a person’s small intestine (is cold) — the small intestine is also tai yang: the hand tai yang small intestine channel and the foot tai yang bladder channel, these two tai yangs both descend and meet. If the yang cannot move, then it cools down; when urine accumulates in the bladder it is cold: when cold, water accumulates below — cold water always stops below; only steam rises above. When it stops below, the bladder is weighted down, and you (feel) “ah, I want to urinate” — fine, you run and squeeze out two drops, come back and still want to run again — frequent urination. We (know) this small intestine is not (hot) enough.

How does Western medicine, which has no concept of cold, treat it? Doctor Ni says it both humorously and warningly:

You show it to a Western doctor; Western medicine has no concept of cold patterns; he says your sphincter has degenerated and lost strength — you can have surgery — it was already very cold, and after the surgery it is even colder, right? And then you open it again, and carry a urine bag, a plastic tube into the bag; the urine bag looks like an AB (bag), hanging at the knee, the tube running down. Rest assured, it will not happen to you; if your enemy gets this disease, it is because you did not tell him — so you learn to help people; an enemy is an enemy, but when he is sick you still save him.

Why is it dangerous when urine cannot be expelled?

If urine cannot be expelled it is very dangerous — why? Because this water will flow backward — this is what we call counter-flow (ni): if it flows backward into the kidneys, it is as if the kidneys were supposed to expel this turbid matter, but cannot — it first flows back into the kidneys, and the disease becomes grave. So a choppy pulse means accumulation — it accumulates.

Wrapping up: tai yang done, next lecture is shao yang

The last sentence speaks of shao yang: shao yang we speak of as the gallbladder and san jiao. When there is jin bi… blood full and insufficient (the content ends here for now) — to be continued next lecture.

So everyone, remember this lecture well: miao ci is the needling method for collateral disease — if there is bruising on the four extremities, let it out; corpse syncope is the five collaterals sick together — bleed all the well points, blow in the ear, shave the left forehead corner, one cup of wine — these first-aid methods, used once in a lifetime, are worth it.

Compiled from Doctor Ni Haixia’s Ren Ji (Human Records) Huang Di Nei Jing lecture series (Lecture 68).